How to do a no hands-on physical in 3 minutes (or less)


Step 1: Greet patient.

Step 2: While chatting, check all boxes in electronic medical record for a complete review of systems and physical exam. Copy and paste parts of previous chart note while looking at patient every once in a while. Smile if possible.

Step 3: Tell patient to do yoga.

Step 4: Bill insurance company for complete physical exam.

Welcome to big box assembly line medicine.

Ever wonder what happens when a doctor goes to the doctor? Same sh*t.

A physician friend recently told me: “My last trip to my PCP was shorter than the time it takes to brush my teeth! If I hear one more suggestion to drink chamomile tea and do yoga … I just don’t need the 3-minute bullsh*t session.”

The truth is health care can’t happen in 3-minute increments. Assembly-line medicine doesn’t work for patients or doctors. Here’s why: doctors aren’t factory workers and patients aren’t widgets.

I shared my physician friend’s experience on Facebook and turns out it’s the norm for many Americans.

E. B. Sheffield writes: “Lol, this made me laugh. The last time I went to see a doctor for a yearly lab and all check, he didn’t touch me. The stethoscope never left his neck, and he kept talking about Suzanne Somers. But he is board certified. Sigh.”

“I’ve had the ‘no-hands’ PE [physical exam] before, which is always really, really, weird to me. I’m a veterinarian and our PEs [exams] are totally hands-on, all over and everywhere …” claims Margaret Brosnahan.

Dr. William Halstead shares, “I thought this only happened to me. Haven’t had a complete physical exam since I finished residency.”

Amina Moghul reports, “Yup, recently developed a tremor, went to a neurologist who didn’t even examine me and shooed me out the door telling me to do yoga because I must be stressed out.”

“My internal med doc spends about 5 to 7 minutes with me,” claims Theresa Stier Brown, “He never listens to my heart/lungs or lays a hand on me. He only asks about my diabetes meds even though I take meds for seven other health problems — so no medication review.”

“I’ve had fraudulent physical exam where no hands on, no listening to heart or lungs but he dictated lungs clear to auscultation and heart rate regular, etc.,” confirms Louann Harrack. “That’s why my primary care is a nurse practitioner. (No offense to the good doctors out there.)”

So what’s a patient to do?

1. Boycott big-box assembly-line medicine.
2. Find a good doctor or nurse practitioner.
3. Can’t find one? Go see a veterinarian.

Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Physician Suicide Letters — Answered and Pet Goats and Pap Smears. Watch her TEDx talk, How to Get Naked with Your Doctor. She hosts the physician retreat, Live Your Dream, to help her colleagues heal from grief and reclaim their lives and careers.

Image credit: Pamela Wible

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